Treating the Anxious or Depressed Parent and the Affected Family
Anxiety disorders are the most common mental illnesses in the U.S., impacting at least 40 million adults aged 18 and older, or 18% of the population. Depression affects 16.1 million U.S. adults aged 18 or older, or about 6.7% of all U.S. adults. Out of every five people you meet, one of them is likely to be suffering from anxiety or depression, or both, since nearly 50% of people diagnosed with depression also have an anxiety disorder.
What do these statistics mean? Many of the people struggling with these disorders — which can affect their ability to work and function in their daily lives — are parents. So how do anxiety and depression affect parenting abilities, families and children?
Anxiety and Depression: A Family Affair
The job of raising another human being is challenging enough as it is. Trying to raise another human being when you are struggling with anxiety or depression can make the parenting job seem next to impossible.
Research shows a connection between parental anxiety and depression and children’s behavior. A parent suffering from anxiety or depression may disengage from their children if they are overwhelmed by the symptoms of their illness.
Alternately, an anxious parent may be overly protective of their children. With a constant barrage of media headlines announcing the dangers in the world — from child abductions, abuse, cyber-bullying and school shootings to pool drownings and road accidents — the parenting job itself can be a trigger for anxiety.
How Parental Anxiety and Depression Affect Children
Children are very tuned into their parents, and can pick up on their parents’ feelings, or apparent lack of feelings, even if they don’t understand the underlying cause.
For example, a parent’s anxieties can be transferred to the children, making them more likely to be fearful or anxious. Or, if children feel a parent is disconnected from them or insensitive to their needs, they will act out. Babies who have a depressed or anxious parent might become fussy or generally more difficult to comfort and care for. Older children may become defiant and tough to manage, challenging adult authority. This can set off a difficult cycle of the parent feeling guilty and powerless or frustrated, believing that their own depression is a result of their child’s problematic behavior. In turn, the child becomes progressively disrespectful and harder to handle.
“The cycle of guilt, powerlessness, depression and anxiety is often repeated through generations of a family,” says Olga Yahontova, MD, psychiatrist at Promises Malibu Vista. “While we are still in the early stages of understanding how the transmission of these dysfunctional patterns takes place in families, it is clear that our own response to trauma is profoundly affected by the traumatic experiences of our genetic ancestors. It is not uncommon to discover during individual trauma work with our clients that there are deeper roots to their symptoms.”
Dr. Yahontova has worked with descendants of Holocaust survivors, people from families of political refugees and those whose families experienced natural disasters. “In many of those cases, we found that helping patients to identify and heal the possible effects of transgenerational transmission of unprocessed trauma resulted in more sustainable remission and better outcomes.”
Genetics also play a role. Children of parents with anxiety and depression are at higher risk for developing these conditions themselves. Research shows that children of depressed parents are also at higher risk for substance abuse and antisocial activities.
The good news is that childhood anxiety is very treatable, but it is important to identify the early signs and symptoms and take immediate steps to address them. Common forms of childhood anxiety include separation anxiety, social phobia and generalized anxiety disorder. It isn’t always easy for parents to know when to seek professional help for their child, but some signs that indicate they might need treatment include:
- If a child refuses to go places or do things, this can be a red flag for anxiety. Also, when a child has persistent fear about doing things that might embarrass them, they are often perceived as shy or self-conscious, but this type of avoidance can be an indicator of anxiety.
- Aches and pains. If a child is often restless and frequently complains of stomachaches, headaches or fatigue, these can be symptoms of anxiety. Muscle tension, sweating, shaking or trembling are other physical symptoms of anxiety in kids.
- Behavioral issues. If a child has a negative reaction or behavior in certain settings that seems disproportionate to the situation, this can be a sign that they are anxious. Exaggerated worry or dread about relatively small, everyday problems can indicate an anxiety disorder.
Helping Mothers Who Experience Depression & Anxiety
Women are 50% more likely than men to have depression, and roughly three times more likely to suffer from anxiety — 60% of women are likely to experience an anxiety disorder over their lifetime. Given these statistics, it is clear that a significant number of children grow up with a depressed or anxious mother.
In clinical practice, the steps we typically follow to help a depressed or anxious mother include:
- Help get Mom some immediate relief through support (i.e., daycare or camp, childcare help from relatives or babysitters)
- Treat Mom’s depression and anxiety, usually through both medication and therapy
- Teach Mom to defuse power struggles with the kids
- Coach Mom on slowly rebuilding affectionate bonds with her children
- Refer Mom and family for ongoing family therapy, as needed
Anxiety and depression are very treatable conditions, and 80% to 90% of patients are helped through a combination of antidepressant medications and focused psychotherapy.
Helping Reduce Worries in Anxious Parents
There are a few general tips that all parents can use to reduce stress and limit anxieties about their children.
- Accept that you are fearful, and then learn the real risks and facts about some of the concerns you have about your children. For example, the rate of child abduction by strangers is actually low (most reported “abductions” are related to custody issues). It is helpful to separate fear from fact.
- Raise your children’s awareness about avoiding strangers and other dangers (i.e., swimming pools, busy streets) so they are more vigilant about their own safety (without making them overly anxious).
- Use relaxation techniques to calm your fears, and teach your children to do the same. (Deep breathing and mindfulness exercises are easy to do and very helpful.)
- Make efforts to reduce the risk of accidents around your home so you can stop worrying. Fence in the pool and add a locked gate; put childproof safety locks on cabinets that hold cleansers and other potential poisons; keep the lawn mower, other machinery and exercise equipment out of reach; use gates to keep kids away from stairs, driveways and other risky areas. All of these represent real risks that you can control.
Dr. Yahontova has found in her practice that often patients seek therapy for the first time in their lives when their children reach the same age they were when they experienced childhood trauma. It is almost as if, unconsciously, the parents are trying to protect their children from the pain they experienced.
“One of the best ways, in my opinion, for anxious parents to help their children is to take care of their own mental health and emotional well-being first,” says Dr. Yahontova. “The well-known metaphor about putting on your own oxygen mask during an airline emergency before you help others put on their masks is very apt in the context of treating the complexities of trauma and anxiety in family systems.”
It is helpful to remember that you cannot control every outcome, and worrying about potential negative outcomes doesn’t help you control things — it only makes you anxious. If you have taken steps to reduce the real dangers around your home, and also taken steps to teach your children to be aware and mindful of their own safety as they move through the world, then you have made the efforts you could to minimize the potential dangers you have some control over.
You need to let your children make their own decisions and choices based on what they have learned. The next step is focusing on yourself and practicing the art of letting go of the things you can’t control, while also taking care of your own health, safety and responsibilities.
Preventing Onset of Anxiety Disorders in Offspring of Anxious Parents: A Randomized Controlled Trial of a Family-Based Intervention. GS Ginsburg et al. The American Journal of Psychiatry, September 2015.